Mackerman Music

     Online Piano

1. Signed Teacher’s Studio Policy form (See Studio Policy under More on right menu)

2. Tuition: (See Tuition under More on right menu)

3. Registration form for each student (below).

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                                    Fall Session 2020 Piano Student Registration

Please complete for each student and bring to your 1st lesson.

Student Name: ________________________________Nickname (if any) ___________________

Home Phone: _________Address: ___________________Grade: ____ Age: __ Birthday______

City, State, Zip ________________________________

School:__________________________________________________________

Mother’s Name/Work Phone:   __________________ Cell Phone: ____________________

Father’s Name/Work Phone:   __________________  Cell Phone:   ___________________  

Preferred app(s) for online lessons:  Zoom, FaceTime

_______________________________________________________

In case I need to contact this student’s parent during the day, and neither parent can be reached at home, please provide at least one work email address below.

Mother’s Email: ____________________________________________

Father’s Email: _____________________________________________

Preferred Interfaces: Facetime ____; Facebook Messenger ____; Skype ____; Zoom ____

Emergency Contact Name: _______________________________________

Emergency Contact Phone: ______________________________________

Student's musical experience (if any):

______________________________________________________________

_______________________________________________________________

Referred by (if anyone):

______________________________________________________________